45 CFR § 180 compliance
C · 70
This hospital published part of what § 180 requires.
●Machine-readable file published
○Gross / standard charges
○Discounted cash price
●Payer-specific negotiated rates
●Min / max negotiated charges
●Free, public, no login required
Procedures listed
19,373
Insurances with rates
26
CPT / HCPCS codes
16,984
Source MRF
Most expensive procedures (gross)
J7165
$13,714
Prothrombin Complex Human-lans (Balfaxar) injection 2,000 Units 80 mL
Gross
$68,569
J2353
$11,049
octreotide (SandoSTATIN LAR) IM injection kit 30 mg
Gross
$55,245
Q5115
$7,362
riTUXimab-abbs (Truxima) 900 mg in sodium chloride 0.9 % 635 mL infusion
Gross
$36,812
90375
$6,254
Rabies Immune Globulin SOLN 1,725 Units
Gross
$31,272
127431
$5,298
dantrolene sodium (Ryanodex) injection 118 mg
Gross
$26,488
127431
$5,298
dantrolene sodium (Ryanodex) injection 118 mg
Gross
$26,488
J3101
$3,979
tenecteplase (TNKase) injection
Gross
$19,894
J2783
$3,539
rasburicase (Elitek) 3 mg in sodium chloride 0.9 % 50 mL IVPB
Gross
$17,694
J1568
$3,105
immune globulin 10 % (Octagam) infusion 10 g
Gross
$15,524
J9171
$2,529
DOCEtaxel (Taxotere) 104 mg in sodium chloride 0.9 % 280.2 mL chemo infusion
Gross
$12,646
J9171
$2,529
DOCEtaxel (Taxotere) 104 mg in sodium chloride 0.9 % 280.2 mL chemo infusion
Gross
$12,646
151276
$2,438
Rabies Immune Globulin SOLN 1,725 Units
Gross
$12,190
A9569
$2,009
technetium Tc 99m exametazime labeled autologous WBC radiopharmaceutical injection 17.2 millicurie
Gross
$10,045
A9521
$1,761
technetium Tc 99m exametazime (CERETEC) radiopharmaceutical injection 15.3 millicurie
Gross
$8,806
7306
$1,684
sodium bicarbonate 4.2 % injection
Gross
$8,422
7306
$1,684
sodium bicarbonate 4.2 % injection
Gross
$8,422
Q5119
$1,560
riTUXimab-pvvr (Ruxience) 596 mg in sodium chloride 0.9 % 604.6 mL infusion
Gross
$7,802
J9073
$1,494
cycloPHOSphamide (Cytoxan) 1,276 mg in sodium chloride 0.9 % 256.38 mL chemo infusion
Gross
$7,470
J9301
$1,439
obinutuzumab (Gazyva) 100 mg in sodium chloride 0.9 % 114 mL infusion
Gross
$7,193
J0585
$1,041
botulinum toxin type A (Botox) injection
Gross
$5,203
J0248
$1,040
remdesivir 100 mg in sodium chloride 0.9 % 100 mL IVPB
Gross
$5,201
A9560
$1,003
technetium Tc 99m labeled red blood cells (ULTRATAG) radiopharmaceutical injection 30 millicurie
Gross
$5,014
A9560
$1,003
technetium Tc 99m labeled red blood cells (ULTRATAG) radiopharmaceutical injection 30 millicurie
Gross
$5,014
J1451
$959
Fomepizole (Antizol) 600 mg in sodium chloride 0.9 % 100 mL IVPB
Gross
$4,795
J7189
$905
coagulation factor VIIa (recomb) (NovoSeven RT) injection
Gross
$4,524
Q9957
$838
Perflutren Lipid Microsphere (DEFINITY) 6.52 MG/ML injection 2 mL
Gross
$4,191
Q9957
$838
Perflutren Lipid Microsphere (DEFINITY) 6.52 MG/ML injection 2 mL
Gross
$4,191
J0630
$831
calcitonin (Miacalcin) 200 UNIT/ML injection 260 Units
Gross
$4,156
J0583
$809
Bivalirudin Trifluoroacetate (Angiomax) 5 mg/mL in sodium chloride 0.9 % 50 mL infusion
Gross
$4,046
J0583
$809
Bivalirudin Trifluoroacetate (Angiomax) 5 mg/mL in sodium chloride 0.9 % 50 mL infusion
Gross
$4,046
J2760
$783
phentolamine (Regitine) 5 mg in sodium chloride (PF) 0.9 % injection for extravasation
Gross
$3,916
J0666
$771
BUPivacaine liposome (Exparel) 1.3 % injection 10 mL
Gross
$3,857
J2997
$766
alteplase (Activase) IVPB
Gross
$3,831
97893
$748
tolvaptan (Samsca) tablet 15 mg
Gross
$3,741
97893
$748
tolvaptan (Samsca) tablet 15 mg
Gross
$3,741
90675
$695
rabies vaccine (Rabavert) injection 1 mL
Gross
$3,473
J2690
$655
procainamide (Pronestyl) 1,000 mg in sodium chloride 0.9 % 50 mL IVPB
Gross
$3,275
A9520
$612
technetium Tc 99m tilmanocept (LYMPHOSEEK) radiopharmaceutical injection 580 microcurie
Gross
$3,059
A9520
$612
technetium Tc 99m tilmanocept (LYMPHOSEEK) radiopharmaceutical injection 580 microcurie
Gross
$3,059
161704
$599
indomethacin 100 MG suppository
Gross
$2,997
161704
$599
indomethacin 100 MG suppository
Gross
$2,997
3901
$578
indomethacin (Indocin) 50 MG suppository
Gross
$2,892
3901
$578
indomethacin (Indocin) 50 MG suppository
Gross
$2,892
8968
$531
acyclovir (Zovirax) 5 % ointment
Gross
$2,656
8968
$531
acyclovir (Zovirax) 5 % ointment
Gross
$2,656
C9088
$483
BUPivacaine-Meloxicam ER (Zynrelef) 400-12 MG/14ML injection 14 mL
Gross
$2,416
J2469
$453
palonosetron (Aloxi) injection 0.25 mg
Gross
$2,263
J2469
$453
palonosetron (Aloxi) injection 0.25 mg
Gross
$2,263
90677
$452
pneumococcal 20-Val conj vaccine (Prevnar 20) injection 0.5 mL
Gross
$2,262
90677
$452
pneumococcal 20-Val conj vaccine (Prevnar 20) injection 0.5 mL
Gross
$2,262
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J7165 | Prothrombin Complex Human-lans (Balfaxar) injection 2,000 Units 80 mL | $68,569 | $13,714 | $1.55 | $54,855 | 70 |
| J2353 | octreotide (SandoSTATIN LAR) IM injection kit 30 mg | $55,245 | $11,049 | $205 | $44,196 | 69 |
| Q5115 | riTUXimab-abbs (Truxima) 900 mg in sodium chloride 0.9 % 635 mL infusion | $36,812 | $7,362 | $30.96 | $29,449 | 69 |
| 90375 | Rabies Immune Globulin SOLN 1,725 Units | $31,272 | $6,254 | $273 | $25,017 | 69 |
| 127431 | dantrolene sodium (Ryanodex) injection 118 mg | $26,488 | $5,298 | $7,947 | $18,542 | 4 |
| 127431 | dantrolene sodium (Ryanodex) injection 118 mg | $26,488 | $5,298 | — | — | 0 |
| J3101 | tenecteplase (TNKase) injection | $19,894 | $3,979 | $158 | $15,915 | 69 |
| J2783 | rasburicase (Elitek) 3 mg in sodium chloride 0.9 % 50 mL IVPB | $17,694 | $3,539 | $360 | $14,155 | 69 |
| J1568 | immune globulin 10 % (Octagam) infusion 10 g | $15,524 | $3,105 | $47.95 | $12,420 | 69 |
| J9171 | DOCEtaxel (Taxotere) 104 mg in sodium chloride 0.9 % 280.2 mL chemo infusion | $12,646 | $2,529 | $0.58 | $10,749 | 52 |
| J9171 | DOCEtaxel (Taxotere) 104 mg in sodium chloride 0.9 % 280.2 mL chemo infusion | $12,646 | $2,529 | — | — | 0 |
| 151276 | Rabies Immune Globulin SOLN 1,725 Units | $12,190 | $2,438 | — | — | 0 |
| A9569 | technetium Tc 99m exametazime labeled autologous WBC radiopharmaceutical injection 17.2 millicurie | $10,045 | $2,009 | $1,012 | $8,036 | 63 |
| A9521 | technetium Tc 99m exametazime (CERETEC) radiopharmaceutical injection 15.3 millicurie | $8,806 | $1,761 | $780 | $7,045 | 63 |
| 7306 | sodium bicarbonate 4.2 % injection | $8,422 | $1,684 | $2,526 | $5,895 | 4 |
| 7306 | sodium bicarbonate 4.2 % injection | $8,422 | $1,684 | — | — | 0 |
| Q5119 | riTUXimab-pvvr (Ruxience) 596 mg in sodium chloride 0.9 % 604.6 mL infusion | $7,802 | $1,560 | $22.94 | $6,241 | 69 |
| J9073 | cycloPHOSphamide (Cytoxan) 1,276 mg in sodium chloride 0.9 % 256.38 mL chemo infusion | $7,470 | $1,494 | $1.76 | $5,976 | 69 |
| J9301 | obinutuzumab (Gazyva) 100 mg in sodium chloride 0.9 % 114 mL infusion | $7,193 | $1,439 | $72.78 | $5,754 | 69 |
| J0585 | botulinum toxin type A (Botox) injection | $5,203 | $1,041 | $6.29 | $4,162 | 69 |
| J0248 | remdesivir 100 mg in sodium chloride 0.9 % 100 mL IVPB | $5,201 | $1,040 | $6.18 | $4,160 | 69 |
| A9560 | technetium Tc 99m labeled red blood cells (ULTRATAG) radiopharmaceutical injection 30 millicurie | $5,014 | $1,003 | $105 | $4,262 | 46 |
| A9560 | technetium Tc 99m labeled red blood cells (ULTRATAG) radiopharmaceutical injection 30 millicurie | $5,014 | $1,003 | — | — | 0 |
| J1451 | Fomepizole (Antizol) 600 mg in sodium chloride 0.9 % 100 mL IVPB | $4,795 | $959 | $5.99 | $3,836 | 69 |
| J7189 | coagulation factor VIIa (recomb) (NovoSeven RT) injection | $4,524 | $905 | $2.48 | $3,619 | 69 |
| Q9957 | Perflutren Lipid Microsphere (DEFINITY) 6.52 MG/ML injection 2 mL | $4,191 | $838 | $41.88 | $3,562 | 52 |
| Q9957 | Perflutren Lipid Microsphere (DEFINITY) 6.52 MG/ML injection 2 mL | $4,191 | $838 | — | — | 0 |
| J0630 | calcitonin (Miacalcin) 200 UNIT/ML injection 260 Units | $4,156 | $831 | $499 | $9,569 | 68 |
| J0583 | Bivalirudin Trifluoroacetate (Angiomax) 5 mg/mL in sodium chloride 0.9 % 50 mL infusion | $4,046 | $809 | $0.15 | $3,439 | 52 |
| J0583 | Bivalirudin Trifluoroacetate (Angiomax) 5 mg/mL in sodium chloride 0.9 % 50 mL infusion | $4,046 | $809 | — | — | 0 |
| J2760 | phentolamine (Regitine) 5 mg in sodium chloride (PF) 0.9 % injection for extravasation | $3,916 | $783 | $316 | $3,133 | 68 |
| J0666 | BUPivacaine liposome (Exparel) 1.3 % injection 10 mL | $3,857 | $771 | $1.41 | $3,085 | 70 |
| J2997 | alteplase (Activase) IVPB | $3,831 | $766 | $88.97 | $3,065 | 69 |
| 97893 | tolvaptan (Samsca) tablet 15 mg | $3,741 | $748 | $1,122 | $2,619 | 4 |
| 97893 | tolvaptan (Samsca) tablet 15 mg | $3,741 | $748 | — | — | 0 |
| 90675 | rabies vaccine (Rabavert) injection 1 mL | $3,473 | $695 | $318 | $2,779 | 69 |
| J2690 | procainamide (Pronestyl) 1,000 mg in sodium chloride 0.9 % 50 mL IVPB | $3,275 | $655 | $145 | $2,620 | 69 |
| A9520 | technetium Tc 99m tilmanocept (LYMPHOSEEK) radiopharmaceutical injection 580 microcurie | $3,059 | $612 | $367 | $2,600 | 45 |
| A9520 | technetium Tc 99m tilmanocept (LYMPHOSEEK) radiopharmaceutical injection 580 microcurie | $3,059 | $612 | — | — | 0 |
| 161704 | indomethacin 100 MG suppository | $2,997 | $599 | $899 | $2,098 | 4 |
| 161704 | indomethacin 100 MG suppository | $2,997 | $599 | — | — | 0 |
| 3901 | indomethacin (Indocin) 50 MG suppository | $2,892 | $578 | $868 | $2,025 | 4 |
| 3901 | indomethacin (Indocin) 50 MG suppository | $2,892 | $578 | — | — | 0 |
| 8968 | acyclovir (Zovirax) 5 % ointment | $2,656 | $531 | $797 | $1,859 | 5 |
| 8968 | acyclovir (Zovirax) 5 % ointment | $2,656 | $531 | — | — | 0 |
| C9088 | BUPivacaine-Meloxicam ER (Zynrelef) 400-12 MG/14ML injection 14 mL | $2,416 | $483 | $0.75 | $1,933 | 69 |
| J2469 | palonosetron (Aloxi) injection 0.25 mg | $2,263 | $453 | $0.5 | $1,923 | 52 |
| J2469 | palonosetron (Aloxi) injection 0.25 mg | $2,263 | $453 | — | — | 0 |
| 90677 | pneumococcal 20-Val conj vaccine (Prevnar 20) injection 0.5 mL | $2,262 | $452 | $271 | $1,923 | 52 |
| 90677 | pneumococcal 20-Val conj vaccine (Prevnar 20) injection 0.5 mL | $2,262 | $452 | — | — | 0 |
Showing top 50 of 19,373 priced procedures, sorted by gross charge.
Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.